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Do I Want Silicon Valley Footing My Egg-Freezing Bill?


The New York Times' Fertility Diary columnist explains why Facebook and Apple's recent announcement to cover employee fertility benefits can only be a good thing.



“Maybe you should think about freezing your eggs,” a married friend from high school said to me back in 2005. I was in my early 30s and had vaguely heard of this futuristic egg freezing thing but I was shocked that a friend would even bring it up.

It’s true I was just dating around, not seriously, but that was because I had a multitude of personal stuff to work out—mainly how to shed my strict religious upbringing—but it was also true that egg-freezing process was still experimental, with a high chance of damaging the eggs.

In the last decade, though, the technology for egg freezing has improved rapidly (the flash-freezing vitrification process replacing the less successful slow-freezing one) and in 2012, the American Society for Reproductive Medicine removed its experimental label from it, making the procedure a very real choice for women today to consider.

But one of the major obstacles, aside from efficacy, has always been price: The process costs about $10,000 for one cycle, with additional fees for egg storage ($500 year). Moreover, oocyte cyropreservation, as egg freezing is called, is not covered by insurance. Even policies that offer coverage for In Vitro Fertilization (IVF) usually exclude egg freezing. (Egg freezing is similar to the first stage of IVF: After priming a woman with hormones to increase her egg production, doctors then extract her eggs. They can then either freeze them for future use, or fertilize them with sperm and transfer resulting embryos back to her, for IVF.)

Now two major companies will foot the bill: Facebook has been offering its employees $20,000 for egg freezing since January, and Apple will follow as of January 2015.

This is great news.

But some don’t see it that way. The New York Times’ “Upshot” column’s headline read “Freezing Eggs as Part of Employee Benefits: Some Women See Darker Message after Apple’s announcement:

“Workplaces could be seen as paying women to put off childbearing,” writes Claire Cain Miller. “Women who choose to have babies earlier could be stigmatized as uncommitted to their careers. Just as tech company benefits like free food and dry cleaning serve to keep employees at the office longer, so could egg freezing, by delaying maternity leave and child-care responsibilities,” who goes on to explain that some are worried that women may feel pressured to use the benefit.

Wait, What?

By offering to cover egg freezing, women will feel societal pressure to do it? Are companies who offer maternity leave pressuring women to have babies? Who has kids just for the pithy maternity leave? I can’t imagine any woman will freeze her eggs if she does not want to.

And that’s the point that people miss when it comes to egg freezing: It’s elective. No one will be forced to use this option. But it’s a good option. No: It’s a great option. Especially in an industry like technology, where to succeed one has to put in 80-hour-work weeks. That doesn’t leave a whole lot of time for dating, for devoting time to forging serious relationships, planning weddings, and birthing babies. This is true for any field that requires such hours, such as finance, law, and medicine (but at least in medicine women are more cognizant of their fertility options).

Are these companies “paying women to put off childbearing?” Or do they realize that working devotedly might come at a cost—and that cost may very well be a woman’s chance to have children.

That is, if egg freezing actually works. Much has been debated over how effective the process is, but the trouble is, there’s not that much evidence either way since the technology is so new (most women using the newer freezing process have not defrosted their eggs yet). Doctors estimate that only 2,000 births have resulted from the process, so far.

The numbers on egg freezing are confusing: On the one hand, statistics from egg-donor programs, which today primarily use frozen eggs from donors under 35, show a 50 to 65 percent success rate. But like with anything else in fertility, it’s dependent on age: The younger you are when you freeze your eggs, the greater chance you have, generally speaking. The Times cited an article in Fertility and Sterility (August 2013), which found that the probability of a live birth after three cycles dropped dramatically with age, from 31.5 percent for women who froze their eggs at age 25 to 14.8 percent at age 40.

Those are not great odds. But what most article and studies fail to mention is to compare egg-freezing success rates to fertility rates at a later age.

Here’s what I mean: Say you’re a 34-year-old Facebook employee with no desire to be a single mom, and you have no serious relationship prospects on the horizon: Should you freeze your eggs now, which would have a 20 to 30 percent chance of resulting in a live baby? Or, should you let your life progress naturally, which might play out something like this: You finally cut things off with the dead-beat hi-tech striver who has no desire to settle down, meet someone new at 37, and at 39, start trying to conceive with eggs that have now deteriorated five years.  

That is one comparison no one is making.

And no one should have to. The debate about fertility is rife enough with anxiety, guilt, and fear-mongering. The question should not be whether a woman should freeze her eggs. After all, that is a personal decision.

What should be part of the national discourse is the question of who is going to pay for it. Who will give women the option to work equally hard as men and not sacrifice their child-bearing potential?

We’ve been talking a lot about women’s work-life balance since the Atlantic published “Why Women Still Can’t Have it All.” But that discussion always focuses on women who already have children, or are in the process of having them. No one thinks about the single women who aren’t ready to have children, no matter their reasons. No one is considering what they have to give up in order to support themselves, excel in their careers, plan for a life that may or not include a partner.

Everybody needs a work/life balance—not only moms, and not only parents.

I remember when I was in my early 30s (back when I didn’t freeze my eggs) and had just taken on a management position. I would sit in the office each day fielding phone calls from staff whose kids were sick, whose husband’s car broke down, who had to run to school for a lice “emergency.” I would be the last one there as my boss had to leave early to pick up car pool, my secretary had to pick up her family’s dry-cleaning.

I had no one to pick up the dry-cleaning for me. I had no one to help me when my car broke down (and I was living in Los Angeles, so that was a major hassle). I had no husband. I had no kids. And every time I wanted to leave work early—to work out, to attend a party or hopefully, a date—I’d get raised eyebrows and salacious comments: “Oooooh, you have a daaate,” they’d say, as if my life were more frivolous because it wasn’t theirs. Because it wasn’t a family.

But it might have well been a path to my future family. Without all those years of dating, I might never have finally figured what I wanted in a man, never met my husband, never started trying to have a family.

Everyone should be able to have options for a work-life balance, be it moms, dads, single women, and men. Everyone should be lucky enough to have some of the services offered by hi-tech companies that provide meals, haircuts, massages—and now egg freezing. I hope more companies begin to offer it, and that one day insurance might cover it too.

Delay child-bearing, or eschew it completely: that should be a woman’s choice. Not one she misses out on because she’s stuck at work. 

 

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